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9. Pathogenesis “Pressure ulcers appear to begin in the subcutaneous tissue between the skin and bone as pockets of edema, indicated ultrasonically by pockets of weak reflections and progress by direct extension into dermal tissue” Paul Quintavalle, DPM Director Virtua Wound Care Center

11. Phase One Pre-Pressure Ulcer

12. Phase Two Pre-Pressure Ulcer

13. Phase Three Pre-Pressure Ulcer

15. Episcan I-200 Ultrasound Scanner

16. Episcan I-200 Ultrasound Scanner Improved monitoring of existing wounds Reveals sinus tracks, wound undermining, and edema

17. Wound Undermining

18. Sinus Tract

19. Measuring Treatment Effectiveness

20. Episcan I-200 Ultrasound Scanner

21. Control Resource Utilization

22. Implement wound care strategies best suited for wound characteristics…… Patient specific Wound specific

23. Episcan I-200 Ultrasound Scanner Reduce exposure to litigation and sanctions “Pressure ulcers are the #1 litigated wound problem in nursing homes and long term care.” Courtney H. Lyder, ND Professor, University of VA

24. Reduce Exposure to Litigation and Sanctions Advanced record keeping Comprehensive electronic record Integrate patient and wound assessment data Integrate treatment protocols and ultrasound images

25. High Resolution Ultrasound for Management of Pressure Ulcers Detection of pressure ulcers before clinical signs are apparent Documentation of the existence of pressure ulcers on admission Targeting treatments to specific anatomical areas Distinguishing between pressure ulcers and friction ulcers Measuring treatment effectiveness Increasing awareness and compliance

26. Episcan I-200 Ultrasound Scanner Conclusion: The Episcan I-200 is a valuable tool for pressure ulcer detection and assessment Can aid in the reduction of the incidence of pressure ulcers Can aid in the treatment of pressure ulcers Can aid in the reduction of liability

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